Ashwin Jathavedam, MD, chief of infectious disease at Englewood Health
News spread last week that Samuel Darnold, quarterback for the New York Jets, has been diagnosed with mononucleosis (more commonly referred to as mono) and will be off the field for the time being. What followed was a flurry of tweets preemptively mourning the Jets season and a whole lot of misinformation spreading about mono.
Many fans were shocked that an adult could even get mono, and that mono could take someone out of a professional sport for several weeks. What may surprise these fans even more is the fact that symptoms from mono can actually persist for months.
“Mono is a virus that your body has to fight on its own; it’s not like strep throat, where you can get a prescription for antibiotics and feel better in a day or two. With mono, just being able to eat can take two weeks—which is why people lose so much weight. Swollen lymph nodes and fatigue can take many weeks to subside,” Ashwin Jathavedam, MD, chief of infectious disease at Englewood Health said.
According to Dr. Jathavedam, it’s not abnormal for a college student who catches mono to miss an entire semester of school while recovering. College-aged, young adults are those most likely to have mono—with the peak incidence between ages 16 to 24.
Causes of Mononucleosis
“Mono is caused by an extremely common virus called Epstein-Barr. Most of us are exposed to this virus at some point—so much so, that when they do blood tests on older adults, around 95% of them have antibodies for Epstein-Barr in their systems. Most of us are able to fight off the virus without getting full-blown mono; others are not as lucky,” Dr. Jathavedam said.
The reason young adults are more likely to have mono is fairly obvious. (See mono’s commonly used moniker: “the kissing disease.”) The most common way to spread Epstein-Barr is through saliva, including by sharing drinks.
Diagnosing and Treating Mononucleosis
Diagnosing mono can be difficult, as it is often mistaken for the flu or, more commonly, strep throat. Many people discover they have mono after being prescribed antibiotics for strep and notice their symptoms persist beyond the 24-48-hour window when strep usually goes away.
Once diagnosed, a person with mono is tasked with riding it out at home, as there is no antiviral regimen that effectively treats mono. A doctor may prescribe medicine to ease the symptoms, like anti-inflammatories or short courses of steroids if there is trouble swallowing. Dr. Jathavedam said the focus of getting through a case of mono should be staying hydrated despite your throat pain—continuing to push fluids and having broth regularly.
The question of when you are no longer contagious with mono is a complex one. You can spread Epstein-Barr while you have an active case of mono, but can also continue to shed the virus after your symptoms have subsided. Those who get the Epstein-Barr virus and never have mono can also spread it.
This is why so many of us are exposed to the virus at some point and, unfortunately, why there is no fool-proof way to prevent getting it, short of living in a plastic bubble. As a rule, not kissing or sharing drinks with people who have active mono is all we can do.
“A major concern for an athlete with mono is that your spleen can get very large and if you are hit while playing it can cause severe, even life-threatening bleeding,” Dr. Jathavedam said.
While it is possible for mono to recur, it is unlikely; and once you fully recover, you can return to your regular activities, confident that mono does not leave any long-term effects.